• Welcome to this TEST Hazard Assessment, we would appreciate you taking some time to test and provide feedback on this template. Once complete please submit to your line manager and also and

  • This document is here to help and assist you in the Risk Assessment and support the customer in delivering a safe and good service.
    Please take a few minutes and complete all elements within this assessment as much as possible, once complete ensure that all signatures are completed.
    Ensure that the customer receives a copy of this Risk Assessment.
    Thank you for your cop-operation.

Customer Information

  • Please provide a job description of the work your are going to carry out to support this Hazard Assessment

  • Customer:

  • Select date

  • Unit Location:

  • Add location
  • Number of Team Members working on this activity?

  • Please ensure that the contents of this risk assessment are shared with all those TM's involved in this activity.

  • Service Technicians Name:

  • Model:

  • Serial No:

  • Please take photograph of the Serial Number of the machine you are working on

  • Engine Hours:

  • Crushing Hours:

Risk Assessment

  • Have you reported in?

  • Are you aware of the customers site safety rules, emergency procedures and rescue plans if working at height?

  • Are you fatigued to complete this task?

  • You should immediately consult with your manager and discuss your well being and agree the next course of action. Your manager should also contact the customer and provide feedback.

  • Do you have the required safe system of work and is this valid for your task?

  • Please select those safe systems of work that apply to this activity

  • Add media

  • Are you and the machine in a safe and suitable environment?

  • Are you able to carry out the task in a safe manner?

  • If you do not think it is possible, PAUSE the job and seek assistance and advice.

  • Is there a requirement to Lock Out/Tag Out the equipment you are working on and have you completed this?

  • Please verify that you have Locked, Tagged and Verified that the isolation's are in place, and secure

  • If a lifting operation is to take place, do you have a lifting plan?

  • Is all lifting equipment certified and in the current test period, is it also suitable for the job?

  • Note any defective equipment:

  • If you are working at height, do you have the correct protection to prevent you falling?

  • Please check your equipment and ensure that you have a clip on point, if you do not PAUSE the job and seek assistance and advice.

  • Do you have all the necessary tools/equipment to work safely?

  • If using hazardous substances, do you have all the relevant safety data sheets and hazardous information?

  • Can I cause something to fall on someone else?

  • Please review your work area and remove those items or secure those items that could fall on others

  • Is there clear access & egress?

  • Can I spill or pollute something?

  • Ensure substances are secure and material is in the correct container, to prevent spills or pollute the environment you are working in. Understand the sites spills process and how to clean up, ensure spill kits are close by.

  • Is there sufficient natural light/arificial lighting to work safely?

  • Can weather conditions, effect or increase hazards within the work environment?

  • Consider weather conditions, and if the weather should change during your activity what are your control measures or changes you will make to ensure your safety and that of the team.

  • Are any power tools to be used in a good and safe condition?

  • Are you or other personnel suitably qualified to operate any of the product/equipment in use?

  • Are you equiped with the suitable PPE?

  • Please select those that apply

  • WARNING - If you are not able to ensure your own safety to any of the above questions, JOB PAUSE, ASSESS and RESOLVE the issue with the customer. If this is not possible then escalate this to your relevant supervisor/manager.

Life Saving Behaviors

  • Can I stand clear of the danger Zone from unstable / suspended loads?

  • Can I follow my my lifting plan: No Plan, No Lift?

  • Can I check that my interlocks and guarding work correctly on my equipment and I never bypass them?

  • Can I position myself in a safe zone in relation to moving equipment?

  • Can I protect myself against falls from height?

  • Do I need to obtain authorization before entering a confined space?

  • Add media

  • Have I PAUSED and asked for help from my supervisor if a condition is not safe or I cannot take these actions. If a near miss occurs, I report it immediately?

  • Has the Scope of Work changed?

  • Then PAUSE The job, review and ensure that the hazards and controls you have in place are correct and have not changed.

  • Service Engineer Print name

  • Please provide signature

  • Select date

  • Customer Print Name

  • Please provide siganture

  • Select date

Method Statement

    Method Statement:
  • Description

Service Report & Customer Sign Off

  • Reason for visit

  • Model:

  • Serial Number:

  • Engine Hours:

  • Crushing Hours:

  • Select date

  • Summary of issues/Work Carried out:
  • Description:

  • Add media

  • Assign Issue too?

  • Outstanding work / Issues:
  • Description

  • Add media

  • Assign Issue too?

  • Advisory to customer

  • Parts used

  • Parts required

  • Service Engineer Print Name:

  • Add signature

  • Select date

  • Customer Print Name:

  • Add signature

  • Select date

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.